System and method for improving hospital patient care by providing a continual measurement of health

ABSTRACT

A system for improving hospital patient care by generating a Health Score. The system includes an interface module for receiving incoming medical data from a patient, a transformation module for transforming each of the medical datum into a transformed Health Score value, and a combination module for combining the transformed Health Score values corresponding to each of the medical datum into a single Health Score. A presentation and comparison module displays the Health Score as a Health Score plot over a predetermined time frame, such that a user may identify health trends in a patient by evaluating said Health Score plot.

RELATED APPLICATION

This application is related to and claims the benefit of priority fromU.S. Provisional Patent Application No. 60/657,365, filed on Feb. 28,2005, the entirety of which is incorporated herein by reference.

FIELD OF THE INVENTION

The present invention relates to a system and method for improvinghospital patient care. More particularly, the present invention relatesto a system and method for providing a continual measurement and displayof each patient's health.

BACKGROUND

One of the major problems in delivery of effective medical treatment inhospitals is the quality and continuity of patient care. A typicalpatient, undergoing a serious procedure in a hospital, may easily seefive or more physicians during a stay, and also many nurses and othersupporting personnel. Maintaining a complete medical record for eachpatient (“charting”) swallows huge amounts of nursing time withoutproviding any guidance to the medical staff on how to improve thepatient's care. The present state of the art in medical care withinhospitals makes very little use of the medical record, which is so bulkyand awkward that it can only be quickly perused by doctors on theirrounds. Such reading of the chart makes it almost impossible to evaluatetreatment modalities, or to detect a patient's declining health in timefor intervention (before a crisis).

During a week's hospital stay, each patient may see many doctors andmany nurses. This makes it extremely difficult to provide continuity ofcare. Every different caregiver must understand the medical record togive the patient optimum care, but the form and content of present-daymedical charting provides no help. Each subsequent physician, whether aconsultant or a shift replacement, is ill-prepared by current methods toobtain a correct overall medical status of the patient, thus posing adanger to the continued care of the patient, particularly in therecovery stages after serious operations

For example, an attending physician, while making rounds in a hospital,may stop in on a patient, see that the patient has good color and issitting up in bed, and thusly satisfied, goes on to his nextappointment. However, if that patient had been walking up and down thecorridors two days ago, and now cannot get out of bed, there is aproblem. The patient may be experiencing a major and potentiallylife-threatening complication.

The essence of this problem is that, although all the medicalinformation is recorded, it is not easily understood. After just a fewdays in the hospital, a patient may have twenty or even one hundredpages in their hospital record, including physician progress reports,nursing evaluations, records of vital signs, test results, heartmonitoring information, and so on. However, even if every doctor andnurse who saw the patient were fully aware of the material in thisrecord, it would not be enough to allow for the best medical carebecause it is very difficult to detect trends in such voluminous data.

The result of this arrangement has been to allow a number of patients inrecovery, post-operation or procedure, to deteriorate to the point ofmedical crisis before addressing their problems. This causes a seriousdrain to the resources of the hospital, and much unnecessary pain andsuffering, even death. It is particularly bothersome because many of theconditions that lead to such crises can easily be avoided if the failingcondition of a patient were discovered hours or days earlier.

One thing that a few hospitals have done is to employ an Early WarningSystem (EWS) as a means for deciding whether a patient needs to betransferred to the ICU. Other hospitals have developed a Modified EarlyWarning System (MEWS). Both existing systems typically use a smallnumber of factors such a pulse, blood pressure, temperature, andrespiratory rate. For each factor, a partial score is given, and all ofthese are then tabulated into a total score, which in turn is expressedas a binary recommendation: whether or not to move the patient into theICU; no other action is suggested, no other information is obtained.

Such systems determine a patient's need to be transferred to the ICU byproviding an emergency alert. However, these systems do not provideassistance to the doctor or nurse in helping to anticipate and therebyavoid medical crises, nor are they helpful to the clinical researcher inevaluating the efficacy of procedures and treatments. They convey nohealth trend information. Also, they are limited in the number offactors analyzed and thus are not very sensitive to general healthconditions. For example, in the above-described example of a patientsitting up and alert in bed, this type of evaluation completely missesthe patient's declining health. Because the patient still does haveacceptable vital signs, he is not moved to the ICU, and neither the EWS,nor the MEWS, would generate an alert. However, if during the twoprevious days, this same patient had been walking around the hospitalhalls, but is now not able to rise from a bed, an important medicaldecline has happened, possibly one that will lead to a medical crises ifnot attended to, even though his major vital signs are still acceptable.Our invention addresses these omissions, providing new continual,sensitive tools for improving medical care.

OBJECTS AND SUMMARY

The present invention overcomes the drawbacks associated with the priorart by providing a system and method for continually tracking the healthof a patient in a hospital. One advantage of such a system is, ingeneral, to allow physicians and nurses and clinical researchers toprovide more effective health care for each patient, especially thosespending several days in a hospital. A second advantage is thathospitals can avoid errors and reduce crisis management by using theinvention's capability to detect trends in a patient's health before thepatient reaches a crisis point. Recognizing a serious decline soonenough to administer proper treatment is a life-saving benefit. A thirdadvantage is that such a system gives physicians and nurses a way inwhich to get the “big picture” of a patient's condition and absorb in aglance perhaps 100 pages of a patient's medical records. This deeperunderstanding, along with this new capability to detect health trends,both short-term (over the space of hours), and long-term (over the spaceof days), is extremely important in delivery of effective medical care.A fourth advantage is to enable an entirely new field of scientificstudy, where medical and surgical treatments can be evaluated by the newmeasurements provided by this invention.

The present invention generates a new measurement of health, hereintermed the patient “Health Score” which is continually plotted anddisplayed to show each patient's medical progress during his hospitalstay. This invention may prove to be a vital aid for improving thequality and continuity of medical care.

To this end the present invention provides a system for improvinghospital patient care by generating a Health Score. The system includesan interface module for receiving incoming medical data from a patient,a transformation module for transforming each of the medical datum intoa transformed Health Score value, and a combination module for combiningthe transformed Health Score values corresponding to each of the medicaldatum into a single Health Score. A presentation and comparison moduledisplays the Health Score as a Health Score plot over a predeterminedtime frame, such that a user may identify health trends in a patient byevaluating said Health Score plot.

BRIEF DESCRIPTION OF THE DRAWINGS

For the purpose of illustrating the invention, there are shown in thedrawings several forms, which are presently preferred, it beingunderstood, however, that the invention is not limited to the precisearrangements and instrumentalities shown.

FIG. 1 is a logical diagram of the Health Score system, in accordancewith one embodiment of the present invention;

FIG. 2 is an installation arrangement of the Health Score system asshown in FIG. 1, in accordance with one embodiment of the presentinvention;

FIG. 3 is a flow chart of the generation of a Health Score chart, usingthe Health Score system illustrated in FIG. 1, in accordance with oneembodiment of the present invention:

FIG. 4 is a sample Health Score chart, in accordance with one embodimentof the present invention;

FIG. 5 is a sample Health Score chart as shown in FIG. 4 with additionalpre-operation information, in accordance with one embodiment of thepresent invention;

FIG. 6 is a sample Health Score chart as shown in FIG. 4 with additionalstatistical reference curves, in accordance with one embodiment of thepresent invention;

FIG. 7 is a sample Health Score chart as shown in FIG. 4 with additionalprincipal corresponding measurement curves, in accordance with oneembodiment of the present invention;

FIG. 8 is a sample Health Score chart as shown in FIG. 4 with additionalprincipal corresponding measurement curves, in accordance with oneembodiment of the present invention;

FIG. 9 is a sample Health Score chart as shown in FIG. 4 with additionalcomponent expansion window, in accordance with one embodiment of thepresent invention;

FIG. 10 is a sample Health Score chart as shown in FIG. 4 withadditional slope lines, in accordance with one embodiment of the presentinvention;

FIG. 11 is a panel of Health Score charts as shown in FIG. 4, inaccordance with one embodiment of the present invention; and

FIG. 12 is a chart showing the correlation between patient Health Scoresand rate of expiration, in accordance with one embodiment of the presentinvention.

DETAILED DESCRIPTION

In one embodiment of the present invention, a Health Score system 10 isprovided for generating and presenting a Health Score chart. The newlyinvented Health Score is a medical reference “figure-of-merit” that isused by a physician or nurse to track the patient's health before,during or after a medical procedure or illness, in order to assist inpreventing that patient from reaching a health crisis. When used in thismanner, the Health Score chart enables the attending physicians andnurses to detect trends in the patient's health over time, particularlyin evaluating post-operative recovery in the hospital. It also providesa statistically significant “outcome” for both clinical studies andretrospective studies of the relative efficacies among various surgicalprocedures or techniques, and among medical treatments and drugs.

In addition to short term intensive use of the Health Score system 10, asimilar modified form may be used on a long term basis by regulargeneral practitioners or other health care facilitates such as nursinghomes. For example, as it stands, yearly physicals are usuallyaccompanied by a series of medial measurements of the patient. Enteringsuch data in Health Score system 10 may be useful in spotting long termdeclining health trends, even if none of the particular medicalconditions have reached a crisis level.

To generate and present the Health Score, as illustrated in FIG. 1,system 10 maintains an interface module 12, a collection module 14, atransformation module 16, a combination module 18, a presentation andcomparison module 20, an alert module 22, and a storage module 24.

Interface module 12 is configured to obtain raw medical input, eitherdirectly from patient monitoring devices, or from attending physiciansor nurses. Collection module 14 collects the raw medical data frominterface module 12, and further collects additional material fromstorage module 24, including the patient's historical medical data aswell as other required general medical data (optional statistics). Theraw medical data is transmitted to transformation module 16, and thestored and historical medical data is sent to presentation andcomparison module 20.

Transformation module 16 receives incoming raw medical data and convertsthis data into a usable format for generating the patient's HealthScore. Transformation module 16 converts raw medical data into a formthat will allow different types of data to be combined. The transformeddata is then sent to combination module 18, which in turn generates apatient's Health Score, using a predetermined algorithm.

Presentation and comparison module 20 receives the calculated HealthScore and prepares a Health Score chart 100, plotting the patient'sHealth Score as a function of time. Alert module 22, generates an alarmfor the attending physicians and nurses when a problem is detected witha patient's Health Score chart 100. Such problems are alerted when theHealth Score of a patient descends below an acceptable threshold,determined in advance by system 10 or set by the attending physician, orif a downward trend is detected. Storage module 24 is configured tostore and retrieve Health Score information at various times during theHealth Score generation and presentation procedure.

It is understood that the above list of modules is intended only as asample of the logical organization of modules within system 10. Forexample, many of the modules may be combined with one another orsubdivided and separated according to their function. Any similar HealthScore system, employing similar logical modules to obtain a Health Scoreis also within the contemplation of the present invention.

Furthermore, it is noted that the modules of system 10, illustrated inFIG. 1, are to show their logical relationship to one another. However,this is not intended to limit the physical construction of such asystem. For example, system 10 may be employed on a single largercomputer or on a series of smaller computers, possibly with differentcomponents residing within different geographical locations, such as theuse of an off-site storage module 24. Any similar health care system 10,employing similar modules to generate a Health Score alert, is withinthe contemplation of the present invention.

FIG. 2 gives a typical example of an arrangement for system 10, showingfive patient recovery rooms 30, in a typical hospital with a centralnursing station 32 that is monitored 24 hours a day. System 10 has alocal terminal 10A in each of the five patient rooms 30 and a mainterminal 10B at nursing station 32.

FIG. 3 is a flow chart outlining the process for generating andpresenting a patient's Health Score via system 10. In step 200, apatient is admitted for a particular illness or surgical procedure andis subsequently connected to system 10. At step 202, various medicaldevices/monitors for obtaining the pertinent raw medical data areattached to the patient, such as blood pressure monitors, heart ratemonitors, etc.

At step 204, interface module 12 begins obtaining the pertinent rawmedical data about the patient and imports this data into system 10.Some data is obtained directly from the attached medical devices or fromelectronic medical records. Other data may be entered into the system byan attending physician or nurse. At step 206, this data is sent tocollection module 14. At step 208, collection module 14 further obtainsany necessary past medical data, most importantly the past Health Scoresof the same patient. The raw data is transmitted to transformationmodule 16, and the historical data is sent to presentation andcomparison module 20.

Next, at step 210, transformation module 16 transforms the raw patientmedical data into a usable format, so that all of the disparate forms ofmedical data can readily be compiled with one another. At step 212, thetransformed medical data is sent to combination module 18, whichconverts that raw transformed medical data into a Health Score using apredetermined algorithm. At step 214, the Health Score is transmitted topresentation and comparison module 20, which uses the current HealthScore, as well as historical data from storage module 24 (past HealthScores), to generate a Health Score chart 100.

A sample Health Score chart 100 is shown in FIG. 4, plotting a patient'sHealth Score, calculated by system 10 as a function of time. Chart 100includes scale markings 102 and label material 104 and a Health Scoreplot 106. This chart 100 shows a sample Health Score plot 106 for apatient recovering from open-heart surgery, for 6 days. Initially therecovery was going well, but at approximately the beginning of thefourth day, health deteriorated. A more detailed description of thecontents and evaluation of a Health Score chart 100 is included below.

At step 216, after Health Score chart 100 has been generated,presentation and comparison module 20 may modify and display the HealthScore chart 100 to healthcare providers, via interface module 12 ofsystem 10. At step 218, presentation and comparison module may furthersave any necessary information to storage module 24.

Finally at step 220, if the Health Score, according to plot 106, fallsbelow a predetermined threshold, alert module 22 informs the healthcareproviders, either through interface module 12 or via some other alarm,that the patient is in need of attention.

It is noted that the above list of steps for generating Health Scorechart 100 via system 10 is intended only to show an exemplarystep-by-step process. For example, several of the steps may be combinedwith one another or possibly one step may be divided into a number ofsubroutines. Any similar process using steps to create a Health Scorechart on a similar system is also with in the contemplation of thepresent invention.

Turning now to a more detailed description of the various modules ofsystem 10, interface module 12 receives raw medical data input at step204, and transmits it to the various collection and processing modules14, 16, 18, 20, 22 and 24 of system 10, at step 206. Typically, theinput may include any number of the medical statistics that are used togenerate the Health Score produced by system 10. Interface module 12 ofsystem 10 may be as simple as a keyboard and monitor, used for manualentry of patient data. Furthermore, it may additionally include a set ofautomated electrical instruments such as pulse clips, automated bloodpressure devices, blood oxygen measuring devices, fluid monitoringdevices or any other standard medical measuring device, attached eitherby wire or remotely to interface module 12.

In addition to providing an interface for receiving medical data on thepatients, interface module 12 may also be configured to present a meansfor users, such as doctors or nurses, to update, modify or review thepatient's Health Score at step 216. Furthermore, interface module 12 mayalso be employed by alert module 22 at step 220 to alert the healthcareproviders that alert module 22 has detected a threshold breach, which isexplained in greater detail below

Collection module 14 is coupled to interface module 12 for receiving thevarious raw patient data at step 206. Collection module 14 accepts thisdata from various ports, including interface module 12 as well as otherprograms, such as electronic medical records (EMR), and stores this datain storage module 24. Thus, in addition to the raw physical patient dataand physician/nurse input obtained from interface module 12, collectionmodule 14 further collects and organizes all of the data necessary togenerate and maintain the Health Score chart 100 of the patient,including collection of historical data, performed at step 208.

In one example of generating a Health Score chart 100, the necessarypatient data that must be collected by collection module 14 of system 10may include: diastolic blood pressure, systolic blood pressure,temperature, pulse, respiration rate, a pain score, skin breakdownscore, EKG pattern, and a set of nursing assessments. Nursingassessments may include: respiration, pain, cardiac, gastrointestinal,genitourinary, nutrition, musculoskeletal, skin, neurological,psycho-social, peripheral vascular, and safety (likelihood of falling).Thus, collection module 14 obtains both past and present data necessaryfor the patient on each of the categories to form Health Score chart100.

Transformation module 16 is configured to transform each of the piecesof medical data obtained from collection module 14 into a numericalquantity at step 210. The transformation performed by module 16 mayinclude any number of mathematical or logical operations.Transformations may also take multiple inputs to produce a singletransformed output. Multiple inputs may include historical data for thispatient or for any given class of patients. For example, if thepatient's pulse is greater then one standard deviation above thatexpected for a certain group of patients at this stage of theirrecovery, then the value of “High Pulse” is one, otherwise it is zero.An example of a transformation for diastolic blood pressure (TDBP) wouldbe:

if diastolic blood pressure (DBP)<50, then TDBP=2;

if DBP>50 and DBP<90, then TDBP=0;

if DBP>89 and DBP<100, then TDBP=1;

if DBP>99 then, TDBP=2.

In this case, either very low values of diastolic blood pressure (lessthan 50), or high values of diastolic blood pressure (greater than 99),are considered dangerous.

Another example of a transformation may be for a nursing assessment. Forexample, if the respiration assessment equals “met standards” then thetransformed respiration rate equals zero. If the nursing assessment forrespiration equals “did not meet standards” then the transformedrespiration rate equals one.

Thus, transformation module 16, after receiving raw data from collectionmodule 14, processes the data and transforms them into numbers for usein generating a Health Score for the patient.

The following serves as an example of a list of typical conversions ofraw medical data into numerical form (“transformed numbers”) bytransformation module 16, for use by system 10 in developing a patientHealth Score:

-   -   if diastolic blood pressure<50 then Transformed Diastolic BP=2    -   diastolic between 50 and 89, then . . . 0    -   diastolic between 90 and 99, then . . . 1    -   diastolic>99, then . . . 2    -   all nursing assessments . . . Met=0 . . . or Not Met=1    -   multiply cardiac, neurological, pain, peripheral vascular,    -   psychosocial, respiratory and skin/tissue assessments by 2    -   if Braden score<18, then . . . 1    -   if Braden score greater or equal to 18, then . . . 0    -   if systolic blood pressure<70, then . . . 3    -   if systolic>69 and <81, then . . . 2    -   if systolic>80 and less than 101, then . . . 1    -   if systolic>100 and <200, then . . . 0    -   if systolic>199, then . . . 2    -   if heart rate<40, then . . . 2    -   if heart rate>39 and <51, then . . . 1    -   if heart rate>50 and <101, then . . . 0    -   if heart rate>100 and <111, then . . . 1    -   if heart rate>110 and <130, then . . . 2    -   if heart rate>129, then . . . 3    -   if respiration<9, then . . . 2    -   if respiration>8 and <15, then . . . 0    -   if respiration>14 and <21, then . . . 1    -   if respiration>20 and <30, then . . . 2    -   if respiration>29, than . . . 3    -   if temperature<95, then . . . 2    -   if temperature>94 and <101.1, then . . . 0    -   if temperature greater or equal to 101.1, then . . . 2    -   If the monitored heart pattern is “atrial fibrillation”, “sinus        rhythm”, “sinus tachycardia” or “paced” then . . . 1    -   If the monitored heart pattern is “sinus bradycardia” then . . .        2    -   If the monitored heart pattern is “atrial flutter” OR “heart        block” then . . . 3    -   If the monitored heart pattern is “junctional rhythm” then . . .        4    -   If the monitored heart pattern is “ventricular tachycardia” then        . . . 5    -   Or if the monitored heart pattern is “ventricular fibrillation”        then . . . 5.        These conversions of patient data into numbers are done solely        for the purpose of example. It is understood that any conversion        of raw medical data into a useable form for further calculation        within the context of system 10 is within the contemplation of        the present invention.

The above conversions of medical data into scaled numbers is geared toassessment of negative factors. However, it is understood that positiveassessments may be included too, resulting in “negative” scaled numbers,that would show a positive affect on the Health Score. For example,transformation module 16 may give a negative scaled number in the eventthat heart rate or lung capacity or other such medical data is not onlyOK, but is in fact at an ideal state.

Combination module 18 is configured to take the transformed quantitiesfrom transformation module 16, apply weighting modifiers, and to combinethem, and then to scale them onto a range, such as a score between 0 and100, at step 212. This score, generated by combination module 18, isbased on the various health factors measured and transformed above, theresulting score being a relative overall Health Score of the patientbeing monitored.

An example of a combination Health Score generated by combination module18, using the “transformed numbers” (as described above) generated bytransformation module 16 of system 10, may be:

Part 1

“Health Sum”=Diastolic Blood Pressure+Temperature+Respiration+SystolicBlood Pressure+Heart Rate+Braden Score+Cardiac Assessment+FoodAssessment+Gastrointestinal Assessment+Genitourinary Assessment+HeartRhythm+Musculoskeletal Assessment+Neurological Assessment+PainScore+Pain Assessment+Peripheral VascularAssessment+Psycho-Sociological+Respiratory Assessment+Safety/FallAssessment+Skin/Tissue Assessment

Part 2

Health Score=100*(30−“Health Sum”)/30Based upon the above formulae, a sample calculation of a patient'sHealth Score could be performed by transformation module 16 andcombination module 18, if the collection module 14 of system 10 foundthe following raw medical data:

-   -   Diastolic Blood Pressure of 95=1    -   Negative nursing cardiac assessment=2    -   Negative nursing respiratory assessment=2    -   Braden Score of 18=0    -   Systolic Blood Pressure of 202=1    -   Heart Rate of 100=1    -   Respiration Rate of 14=0    -   Temperature of 98=0    -   Heart Rhythm of sinus bradycardia=2    -   “Health Sum”=(totaling of all above)=9        Health Score=100*(30−“Health Sum”)/30=100*(30−9)/30=70        Such transformations and calculations are intended only to be a        simple example of determining a Health Score, as performed by        system 10. However, it is in no way intended to limit the        possible methods of calculating the score. For example, not all        measured raw medical data need to be incorporated into a Health        Score. The attending physician may wish to generate the score        using only limited data to prevent non-essential medical data        from significantly altering the Health Score.

Another example would be to include the use of weighting factors (2times, 3 times, etc.) that can be added or multiplied to certaintransformed numbers, such as the respiratory factors, when a particularpatient is recovering from a lung-based ailment such as pneumonia.Likewise, similar weighting factors can be added to the transformedscores of heart rate, heart rhythm, systolic and diastolic pressure forpatients with heart ailments. It is understood that any number ofmodifications introduced into a similar combination module 18 within asimilar system 10 for generating a Health Score is within thecontemplation of the present invention.

Presentation and comparison module 20 of system 10 is configured toimport the various data components compiled by combination module 18 andto create a Health Score chart 100 for the patient at step 214, anddisplay it via interface module 12 of system 10, or on an existingmedical information system, such as the hospital's pre-existing computersystem. As discussed above, FIG. 4 illustrates a sample Health Scorechart 100 generated by system 10 using the above-described modules.Additional functions of comparison module 20 are shown below which edit,modify or otherwise present various versions of Health Score chart 100,performed by system 10 at step 216.

Health Score chart 100 is for displaying the Health Score of a patientat particular times, and more importantly, is for detecting trends in apatient's health. Thus, Health Score chart 100 includes a number ofHealth Score assessments taken frequently, both at periodic (e.g. every15 minutes, or every 3 hours), or at irregular intervals. This generatesthe Health Score chart 106 as shown in FIG. 4, plotting the patient'sHealth Score versus time as set by scales 102.

For example in FIG. 4, the Health Score of the patient is computed tentimes a day, approximately every 2 hours over the course of the six-daypost-operative stay. During the first four days, the patient progressedfrom an average Health Score in the low 60s to the high 80s. But shortlythereafter, at the beginning of the fourth day, the patient's scorebegan to decline back into the 60s range.

It is at this particular moment, at the beginning of the fourth day,that the Health Score chart 100 can prove to be a critical tool formedical care. If an attending physician were to see this patient at theend of day 4 without the Health Score chart, the patient's vitalstatistics would show a person of decent physical health. Thiscorresponds to the score of 70 on the health chart, which is aboutaverage health during a post-operation recovery, according to thisexample. Thus without the chart 100, the patient would exhibit decenthealth, and the attending physician would have to rely his own quickperusal of the patient's medical records.

However, with the Health Score chart 100 available, it would be obviousto a physician or nurse that something is going wrong with the patientat the end of day 4. This is a critical time for the patient, becauseimmediate treatment may prevent a crisis. The new information conveyedby chart 100, beyond what is normally available (that the patient iscurrently in an acceptable state), is that: less than 1 day ago, thispatient was in a much better general state of health and is currently ina state of declining health. Thus by intervening in the situation rightat the beginning of day 5, the doctors were able to be stabilize thepatient without further significant decline, so that he could bereleased from the hospital at the end of day 6.

Comparison module 20 may be used to generate and present pre-operationreference curves. Information from pre-operation 108 may be posted onthe patient's Health Score chart 100 so as to give additional context totheir condition. For example, before an operation, the patient may haveexhibited a Health Score of 50. After the operation, the doctors mayexpect the patient to be significantly better. Since before theoperation he had a Health Score of 75, we expect that, although he willgo through some difficult periods during recovery, he will get back to75 within a week. This acts as a baseline reference, to help betterpersonalize the chart 100 to each patient. FIG. 5 shows an example ofpre-operation Health Score information 108, included on a typical HealthScore chart 100, with a pre-operation Health Score of 80.

Statistical reference curves 110 may also be added to Health Score chartby comparison module 20. For example, when such information isavailable, statistically computed average patient Health Scoretrajectories, for each specific procedure and initial patient condition,may be included on chart 100 next to the Health Score plot 106. Thisinformation may be stored in a storage module 24, and be imported intocomparison module 20 by collection module 14. Statistical referencecurves 110 may include linear information with standard deviation errorbars or transformed values. If the patient is below expectation by acertain number of standard deviations, the system generates an alertusing alert module 22, as discussed below.

For example, in FIG. 6, on the Health Score chart 100, the line labeled“Standard Open Heart” may be a statistical reference curve 110 of theaverage recovery of an open-heart surgery patient of age 80. The HealthScore plot 106 labeled “Jane Smith—Room 7A” is the actual Health Scorerepresentation of the recovery of Jane Smith. One sees that although Ms.Smith has steadily improved since her operation, for the last severaldays she has improved at a much slower rate than would be expected whencompared to average (past) patients of the same age undergoing a similarprocedure. Statistical reference curves 110 can be compiled from currentpatients or an evaluation of past patients by using their records togenerate Health Score histories.

Further subdivisions can also be made for such statistical referencecurves. For example, instead of having a single reference curve 110 foraverage open-heart patients of age 80, it can be further broken down bygender, and even further modified as to a patient's initial condition byusing only patients with similar Health Scores at the time of admissioninto the hospital.

Principal corresponding measurement curves 112 may also be generated bycomparison module 20 of system 10. The Health Score chart 100 providesan instant context and patient health trajectory on Health Score plot106. It is also important for healthcare providers to have access toother direct measurements. FIG. 7 illustrates a typical Health Scorechart 100 that includes these direct medical measurements 112. Themeasurement curves 112 may include but are not limited to: diastolicblood pressure, temperature, respiration rate, pulse, and pain score.This allows healthcare providers to detect other trends that may beaffecting the Health Score and, thus, the patient.

In the example in FIG. 7, the patient has a severely reduced HealthScore from December 12 through December 15. By looking at theaccompanying principal corresponding measurement curves 112, it can beseen that the patient had developed a fever on the 12^(th) and was alsodealing with Atrial Fibrillation. By the 16^(th) these conditions hadbeen resolved, with a corresponding sharp increase in Health Score.

FIG. 8 is another example of adding principal corresponding measurementcurves 112 to a standard Health Score chart 100. In this example, it canbe seen that the Principal Corresponding Measurement curves 112themselves are important. The line at the bottom of the Health Scorechart 100 is “pain scale” which is an evaluation of the patient's painlevel. It is scaled between zero and ten. This patient is experiencingsignificant pain almost exactly every 24 hours. This situation may bethe result of a poor pain management strategy; the patient isunder-medicated until he experiences a crisis, at which time a largedosage of medication is administered. Evaluation of the chart wouldprompt modification of this patient's pain medication frequency anddosage.

It is understood that, when using the option of adding direct medicaldata to the Health Score chart 100, system 10 has the ability to let thehealthcare provider select which principal corresponding measurements112 they would like to see. When the Health Score is improving or isadequate, such features may be toggled off, as they are less importantin such instances. They can easily be added to chart 100 if the score onplot 106 again drops, allowing the healthcare provider, optionally, tohave additional analysis tools for determining the cause of the drop.

In another embodiment, presentation and comparison module 20 may beconfigured to alter Health Score chart 100, so that when a healthcareprovider detects a trend in the Health Score plot 106, they canunderstand exactly what factors are contributing. To this end, asillustrated in FIG. 9, system 10 provides for a component expansionwindow 114, such that if the patient has a Health Score of 65 (forexample), the expansion might show that the patient lost 12 points dueto elevated temperature (over 101 Fahrenheit), lost 18 points due torapid pulse (between 100 and 110 beats per minute) and lost 5 points dueto a pain score of 5; all out of the perfect Health Score of 100.

In another embodiment, presentation and comparison module 20 may alsoalter Health Score chart 100 to obtain certain kinds of slopeinformation. Even though trends are usually easy to spot by eye uponlooking at Health Score plot 106, an automatic “simple” slopecalculation may also be useful. Mathematically, this is the firstderivative of the Health Score as a function of time. Due to the“noisiness” of typical Health Score plots 106, some averaging methodsmay be employed as well. If the slope is positive, the patient isprobably getting better; if it is approximately zero, then the patientis staying the same; and if it is negative, then the patient is probablygetting worse. Slope lines 116 may be added to the Health Score plot106, as shown in FIG. 10. Such slope information may help identifytrends in Health Score plot 106, particularly, when plot 106 is “noisy”due to large variations between each Health Score measurement. Althoughnormally “staying the same” would not be considered a negative, in thesituation where the patient is expected to be recuperating, “staying thesame” may be quite worrisome. In the present example, although the mostrecent Health Scores on plot 106 are constant at about a level of 70,the slope line 116 shows a negative slope, taking into account priorpoints, including a time early on day 4 when the score was closer to 90.

Presentation and comparison module 20 of system 10 may also compute“rate of change” of the simple slope. For instance, although the patientis still getting better, the rate of improvement may be decreasing. Thisslow-down in recovery could be evidence of a problem just beginning todevelop. Mathematically, this curvature information is the secondderivative of Health Score as a function of time. Similar to the slopedata 116, due to the “noisiness” of the curves, averaging is included inthe computation. It is understood that attending physicians can adjustthe slope calculation to include more or less reference Health Scoresfrom plot 100 depending on the time span over which the physicianintends to analyze.

When the raw data is noisy, a “running average” or other “smoothing” ofthe Health Score can be displayed on Health Score charts. The smoothedHealth Score curve 118, shown in FIG. 10, could incorporate both the1^(st) derivative (slope) and/or the 2^(nd) derivative (curvature) bycolor-coding or by thickness of the displayed line. For example, if thepatient was getting worse (negative slope), the line might be coloredred. If the patient is getting worse at an accelerating rate, or isgetting better at a lessening rate, then the line could be bolded foremphasis.

Presentation and comparison module 20 may further display a panel ofHealth Score charts 120, as shown in FIG. 11. Typically, a nurse or adoctor or a unit supervisor wants to see, on a single page, the graphsfor all the patients in their care. Therefore, system 10 provides forthe creation of a patient panel 120, displaying a series of Health Scorecharts 100. Patient IDs can be included in the label data 104 toidentify each chart 100 on panel 120. This is especially useful becausean attending physician may wish to appoint more of his time to patientswith falling Health Scores (rather than rising ones), given that thosepatients with falling scores will likely require more attention andgiven that the physician's time is usually very limited.

It is understood that such modifications to patient Health Score charts100 are intended only as example modification and are in no way intendedto limit the scope of the present invention. Any similar invention thatutilizes modified Health Score charts 100 is also within thecontemplation of the present invention.

In one embodiment of the present invention, as illustrated in FIG. 1,alert module 22 may send an alert to an attending physician orsupervising nurse that a Health Score of a particular patient has fallenbelow a pre-determined threshold at step 220. For example, if anattending physician sets a threshold of 70, then patients falling belowsuch a level will cause alert module 22 to send an alert message tosystem terminal 10B at nursing station 32. Although the physician maywish to see Health Score charts 100, regardless of the alerts, alertmodule 22 acts a reserve precaution warning of the general failinghealth conditions of a patient who may be approaching a crisissituation. It is understood that the alert may actually be set to anupper threshold as well. Keeping physicians aware of improving healthconditions of certain patients may be useful in making dischargedecisions or in adjusting medication. Alerts may also be triggered by afall of so many points in Health Score or by a slope that is of asufficient negative magnitude.

As such, the above-described system 10 and accompanying generated HealthScore charts 100 provide a convenient means for monitoring patienthealth status, particularly in hospital post-operational situations. Itallows doctors to get a feel for the overall health of the patient andto detect trends in the patient's health. Such information isparticularly useful in preventing crisis situations from arising inpatients, where the worsening condition (of a patient of adequate, yetdeteriorating health) is overlooked until it is too late. The creationof the Health Score chart 100, by the present invention, helps inalerting attending physicians, nurses, or “rapid response teams” todeteriorating conditions, even when a spot check of the patient's healthwould seem to show the patient to be in an adequate state of health.

In addition to the uses outlined above, the Health Score can be used forstatistical analysis. For example, the Health Score and the Health Scorecharts 100 can be used in retrospective research. Many studies of drugsand procedures are published monthly. These studies would benefit fromthe inclusion of a readily computable Health Score.

For example, a procedure is often evaluated in terms of mortality rate,length of hospital stay, or number of re-admissions to the hospital.These measures are all significant, but at the same time are all rathercrude measures. For example, if “Procedure A” has a mortality rate of0.5% and “Procedure B” has a mortality rate of 0.7%, it may be verydifficult to judge one the superior of the other, using only thesemortality statistics. However, if patients discharged after Procedure Ahave an average Health Score of 80, and those discharged after ProcedureB have an average Health Score of 60, there may be a real and meaningfuldifference between the two procedures in terms of overall efficacy intreating the patient. Thus, system 10 may provide a more sensitivemeasurement of health than any other available measure, since it is notbased solely on major “outcomes” (like discharge or death), but ratheron a more subtle combination of overall health factors. A medical studyusing the Health Score, which this invention makes readily available forevery patient, would find earlier and easier and more meaningful“statistical significance” than a similar study that needed to wait foreventual mortality outcomes.

An additional feature of Health Scores generated by system 10 is thatthe Health Score can be used as a predictor to assist in determiningwhich patients require the most care. Although individual symptoms andraw medical data may be varied, the amalgamated Health Score, as shownon Health Score charts 100, tends to be an accurate predictor of patientoutcome. For instance, using Health Score data generated post facto,FIG. 12 shows actual graphic correlation between Health Scores fromsystem 10 (computed at transfer to the ICU from a regular ward of thehospital) versus the rate of predicted expiration after an ICU stay. Thechart shows a precipitous decline in survival rates when the patienthas, incoming to the ICU, an overall Health Score below 65. In suchinstances, ICU units admitting patients with Health Scores below 65 maychoose to divert additional resources to these patients, in order toreduce morbidity and mortality rates. The Health Score is a sensitivenew tool for the ICU use. In this example, patient “A” with a HealthScore of 65, versus patient “B” with a Health Score of 75, might notexhibit obviously different symptoms, and thus the patients might betreated similarly if the Health Score were not available. But when thedoctors know that there is a statistically significant decline insurvival rate when the Health Score is 65, patient “A” may get theadditional care that would save his life.

Furthermore, incoming Health Scores can be used as an indicator ofsurvival rates before undergoing certain procedure. Not all patients areequal when entering the hospital for a procedure. In some cases, adecision “not to operate” may be made if the risks of complication aretoo great. An admission-timed Health Score from system 10 may alsoprovide statistical information for post-operative survival rates, whichcould greatly influence a hospital's decision to recommend the use ofsurgery, versus alternative treatments.

While only certain features of the invention have been illustrated anddescribed herein, many modifications, substitutions, changes orequivalents will now occur to those skilled in the art. It is therefore,to be understood that this application is intended to cover all suchmodifications and changes that fall within the true spirit of theinvention.

1. A system for improving hospital patient care by continually plottingand displaying health scores as a function of time, the systemcomprising: an interface module, executing on a computer, for receivingincoming disparate medical data relating to a patient collected at apoint in time, the incoming disparate medical data including at leastone datum from a nursing assessment, wherein the nursing assessment isperformed by a nurse; a transformation module, executing on a computer,for transforming each of the incoming disparate medical data collectedat the point in time into a transformed numerical quantity health scorevalue, wherein each of the transformed health score values are in aformat for combining together; a combination module, executing on acomputer, for combining each of the transformed health score valuescorresponding to each of the incoming disparate medical data into asingle health score, the single health score representing the health ofthe patient at the point in time at which the incoming disparate medicaldata was collected; and a presentation and comparison module, executingon a computer, for continually plotting and displaying on a health scoreplot single health scores that have been calculated for the patient as afunction of time, wherein each of the single health scores displayed ata given point in time are recalculated using any new incoming disparatemedical data and represent the health of the patient at the given pointin time, such that a user may identify health trends in the patient as afunction of time by evaluating the health score plot.
 2. The system ofclaim 1 further comprising: a storage module, executing on a computer,for storing past health scores and related historical medical data ofthe patient; and a collection module, executing on a computer, forreceiving the incoming disparate medical data from the interface moduleand for collecting the stored past health scores and related historicalmedical data of the patient from the storage module, wherein thecollection module sends the incoming disparate medical data and thestored past health scores and related historical medical data of thepatient to at least one of the transformation module and thepresentation and comparison module.
 3. The system of claim 1, furthercomprising an alert module, executing on a computer, for alerting theuser when a health score falls below a predetermined threshold.
 4. Thesystem of claim 1, wherein the transformation module transforms each ofthe incoming disparate medical data into a scaled number and wherein thecombination module adds together the scaled numbers, and applies apredetermined algorithm to the added scaled numbers to generate thehealth score.
 5. The system of claim 4, wherein the user can modify thealgorithm used to generate the single health score based on an illnessor condition of the patient.
 6. The system of claim 1, wherein thepresentation and comparison module includes a statistical referencecurve on the health score plot.
 7. The system of claim 1, wherein thepresentation and comparison module further supplies principalcorresponding measurements of direct medical data on the health scoreplot.
 8. The system of claim 1, wherein the presentation and comparisonmodule displays a smoothed health score curve that provides a runningaverage of the health score plot over time.
 9. The system of claim 8,wherein the smoothed health score curve plot incorporates at least oneof a slope and a curvature.
 10. The system of claim 1, wherein the atleast one datum from the nursing assessment includes at least one of:respiration, pain, cardiac, gastrointestinal, genitourinary, nutrition,musculoskeletal, skin, Braden score, neurological, psycho-social,peripheral vascular, and safety.
 11. A method for improving hospitalpatient care by continually plotting and displaying health scores as afunction of time, the method comprising the steps of: receiving, on acomputer, incoming disparate medical data related to a patient andcollected at a point in time at an interface module, the incomingdisparate medical data including at least one datum from a nursingassessment, wherein the nursing assessment is performed by a nurse;transforming, on a computer, each of the incoming disparate medical datacollected at the point in time into a transformed numerical quantityhealth score value at a transformation module, wherein each of thetransformed health score values are in a format for combining together;combining, on a computer, each of the transformed health score valuescorresponding to each of the incoming disparate medical data into asingle health score at a combination module, the single health scorerepresenting the health of the patient at the point in time at which theincoming disparate medical data was collected; generating, on acomputer, a health score plot of single health scores that have beencalculated for the patient as a function of time at a presentation andcomparison module, wherein each of the single health scores arerecalculated using any new incoming disparate medical data and representthe health of the patient at a point in time; and continually plottingand displaying, on a computer, the health score plot such that a usermay identify health trends in the patient as a function of time byevaluating the health score plot.
 12. The method of claim 11, furthercomprising the steps of: storing, on a computer, past health scores andrelated historical medical data of the patient in a storage module;receiving, on a computer, the incoming disparate medical data from theinterface module; collecting, on a computer, the stored past healthscores and related historical medical data of the patient from thestorage module at a collection module; and sending, on a computer, theincoming disparate medical data and the stored past health scores andrelated historical medical data of the patient to at least one of thetransformation module and the presentation and comparison module. 13.The method of claim 11, further comprising the step of alerting, on acomputer, the user when a single health score falls below apredetermined threshold via an alert module.
 14. The method of claim 11,further comprising the steps of: converting, on a computer, each of theincoming disparate medical data into a scaled number at thetransformation module; adding, on a computer, the scaled numbers; andapplying, on a computer, a predetermined algorithm to the added scalednumbers to generate a health score at the combination module.
 15. Themethod of claim 14, wherein the algorithm used to generate the singlehealth score is modified based on an illness or condition of thepatient.
 16. The method of claim 11, further comprising the step of:including a statistical reference curve on the health score plot via thepresentation and comparison module so that the health score plot can becompared to a health score plot of a patient with similar conditions andcircumstances.
 17. The method of claim 11, wherein the presentation andcomparison module further supplies principal corresponding measurementsof direct medical data on the health score plot.
 18. The method of claim11, wherein the presentation and comparison module displays a smoothedhealth score curve that provides a running average of the health scoreplot over time.
 19. The method of claim 18, wherein the smoothed healthscore curve incorporates at least one of a slope and a curvature. 20.The method of claim 11, wherein the at least one datum from the nursingassessment includes at least one of: respiration, pain, cardiac,gastrointestinal, genitourinary, nutrition, musculoskeletal, skin,Braden score, neurological, psycho-social, peripheral vascular, andsafety.